Medicare solutions for individuals and groups

Overview

For those retirees who live in Massachusetts and select neighboring cities and towns, we offer Fallon Senior Plan Premier HMO. The Fallon Senior Plan Premier HMO network is statewide and includes some of the best local providers, including:

• UMass Memorial Health Care
• Lahey Hospital & Medical Center
• MetroWest Medical Centers
• Lowell General Hospital
• Mercy Medical Center
• South Shore Hospital

See the entire hospital and medical group list

A Medicare Advantage plan, Fallon Senior Plan Premier HMO provides more benefits and extras than Original Medicare alone, including:

• $0 annual wellness exams, plus additional health screenings at no cost!
• $0 annual supplemental physical exams
• Part D prescription drug coverage with no deductible and no coverage gap
• The SilverSneakers^® Fitness program, which includes a free basic membership at participating
  nationwide fitness centers. This gives you access to amenities such as treadmills, weights, heated
  pool and fitness classes.
• $150 toward the purchase of eyewear every year.
• Preventive dental care, including dental checkups (two every year), coverage for fillings, root canals,
  and more.*
• A hearing aid benefit of up to $500 toward the purchase of hearing aids every 36 months.

Eligibility

To be eligible for Fallon Senior Plan Premier HMO, members must:

• Be eligible for a Medicare group plan through an employer or a union health and wellness organization
• Be enrolled in Medicare Part A and Part B
• Continue to pay their Medicare Part B premium or have it paid for by another source
• Reside within the approved service area.

Service area

To be eligible for Fallon Senior Plan Premier HMO, retirees must live in the service area. The Fallon Senior Plan Premier HMO service area includes all of Barnstable, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester counties. It also includes parts of Franklin County (Erving, New Salem, Orange, Warwick, Wendell and Wendell Depot) as well as some cities and towns that neighbor Massachusetts (shown in green, yellow and blue on the map).

See a larger version of this map

Overview

Fallon Companion Care is our coast-to-coast health care coverage solution for your Medicare eligible retirees, whether they live in Wellfleet or West Palm Beach.

Like Fallon Senior Plan Premier HMO, Fallon Companion Care offers more than Original Medicare alone. And, since Fallon Companion Care doesn’t have a provider network, retirees can choose any provider who accepts Medicare and is most convenient for them.

Fallon Companion Care acts as a secondary payer for Medicare-approved services, and covers costs not paid by Medicare for services such as:

• Tests and screenings, including X-rays and labs
• Outpatient prescription drugs
• Inpatient hospital care
• Durable medical equipment, including wheelchairs and oxygen
• Emergency care inside and outside the U.S.

Fallon Companion Care also includes the It Fits! benefit—a $200 annual fitness reimbursement that members can use for anything from gym memberships at the gym of their choice to yoga classes and ski lift tickets.

Eligibility

To be eligible for Fallon Companion Care, members must:

• Be eligible for a Medicare group plan through an employer or a union health and wellness organization
• Be enrolled in Medicare Part A and Part B
• Continue to pay their Medicare Part B premium or have it paid for by another source.

Service area

Fallon Companion Care is available to your retirees who live anywhere in the United States.